Trauma+team

INTRODUCTION: Trauma to the pelvic ring and associated haemorrhage represent a management challenge for the multidisciplinary trauma team. In up to 10% of patients, bleeding can be the result of an arterial injury and mortality is reported as high as 89% in this cohort. We aimed to assess the mortality rate after pelvic trauma embolisation and whether earlier embolisation improved mortality. METHODS: Retrospective study at single tertiary trauma and referral centre, between 1 January 2009 and 30 June 2022...

BACKGROUND: The Army Medical Department (AMEDD) Military-Civilian Trauma Team Training (AMCT3) Program was developed to enhance the trauma competency and capability of the medical force by embedding providers at busy civilian trauma centers. Few reports have been published on the outcomes of this program since its implementation. METHODS: The medical and billing records for the two AMCT3 embedded trauma surgeons at the single medical center were retrospectively reviewed for care provided during August 2021 through July 2022...

INTRODUCTION: Emergency department (ED) admissions for non-work-related injuries and illnesses in the migrant worker (MW) population in Singapore are not well studied. We aimed to examine ED triage acuity and bills associated with admissions among MW for non-trauma, workplace injury (WI) trauma, and non-workplace injury (NWI) trauma. METHODS: In this retrospective observational study, we included all work permit holders admitted to hospital via the ED of three public hospitals from 1 May 2016 to 31 October 2016...

BACKGROUND: The Rural Trauma Team Development Course (RTTDC) is designed to help rural hospitals better organize and manage trauma patients with limited resources. Although RTTDC is well-established, limited literature exists regarding improvement in the overall objectives for which the course was designed. The aim of this study was to analyze the goals of RTTDC, hypothesizing improvements in course objectives after course completion. METHODS: This was a prospective, observational study from 2015 through 2021...

BACKGROUND: Trauma team leadership is a core skill for the practice of emergency medicine (EM). In this study our goal was to explore EM residents' perception of their trauma leadership skill development through formal and informal processes and to understand factors that may impact the development and implementation of trauma leadership skills. METHODS: Using qualitative semi-structured interviews, we explored the leadership experiences of 10 EM residents ranging from second to fourth postgraduate year...

A female was admitted to a Major Trauma Centre with an isolated thoracic spine stab injury involving a retained knife. The patient was haemodynamically stable with an unremarkable peripheral neurological examination. A CT scan with three-dimensional image reconstruction showed the knife blade lodged in the T11 vertebra with its tip close to the spinal cord, aorta and inferior vena cava. A multidisciplinary trauma team, including anaesthetists, vascular, neurosurgeons and general surgeons, agreed on the treatment strategy...

BACKGROUND: The American College of Surgeons requires continuous process improvement review to maintain trauma center verification. Paper-based systems to monitor and track performance improvement are commonly used but can be inadequate to monitor concurrent ongoing improvement effectively. OBJECTIVE: To describe the implementation of an electronic process to capture and monitor performance improvement in near real time. METHODS: In 2020, a Midwestern U...

BACKGROUND: Hip fracture patients are a subset of trauma patients with high peri-operative mortality. To mitigate the mortality risk, the use of predictive scoring systems (e.g., RSI or Nomograms) for risk stratification and monitoring of high-risk patients in the intensive care unit (ICU) has been proposed. Screening patients for ICU admission with relatively low-cost tools may achieve high-quality, low-cost care. The aim of this study was to assess the effectiveness and feasibility of screening postoperative hip fracture patients for ICU admission...

BACKGROUND: MRI is being reported with increased frequency as an adjunct to spinal soft tissue evaluation in cervical spine trauma. However, the utility of this information remains controversial. OBJECTIVE: To review the utility of MRI in patients with Cervical Spine trauma. METHODS: Consecutive observational study. We identified patients in real-time over a 2-year period as they presented to our Level 1 trauma center, undergoing cervical spine CT followed by MRI...

Management of a trauma patient is a challenging process. Swift and accurate clinical assessment is required and time-sensitive decisions and life-saving procedures must be performed in an unstable patient. This requires a coordinated response by both the emergency room (ER) and operating room (OR) teams. However, a team of experts does not necessarily make an expert team. Root cause analysis of adverse events in surgery has shown that failures in coordination, planning, task management and particularly communication are the main causes for medical errors...

OBJECTIVE: This study investigated issues related to noise, lighting, and temperature in trauma rooms that impact patient care and staff performance. BACKGROUND: Uncontrolled sensory stimuli can hinder healthcare delivery quality in trauma rooms. High noise and temperature levels can increase staff stress and discomfort as well as patient discomfort. Conversely, proper lighting can decrease staff stress levels and reduce burnout. Sensory overload in trauma rooms is a crucial concern, but no studies have been conducted on this issue...

BACKGROUND: The benefits of helicopter emergency medical services (HEMS) transport of adults following major trauma have been examined with mixed results, with some studies reporting a survival benefit compared to regular emergency medical services (EMS). The benefit of HEMS in the context of the Swedish trauma system remains unclear. AIM: To investigate differences in survival and prehospital time intervals for trauma patients in Sweden transported by HEMS compared to road ambulance EMS...

BACKGROUND: Early recognition and initial treatment of trauma patients prevents deterioration and buys time for making a definitive diagnosis. The "Airway, Breathing, Circulation, Disability and Exposure" (ABCDE) approach should be used whenever an injury is suspected. It provides quick identification and management of life-threatening problems. Still, there is limited knowledge regarding adherence to the ABCDE approach. This research aims to assess the adherence of the trauma team members to the ABCDE approach in the management of major trauma patients and the factors affecting it...

INTRODUCTION: It is only in recent years that major trauma systems and networks have been operating in the UK. High-quality data is available from the Trauma Audit and Research Network (TARN) database, enabling regional analysis. Our aim was to analyse Trauma Team Activations within the Cheshire and Merseyside major trauma network and discuss the implications of these data on resource allocation, training and trauma prevention. METHODS: A retrospective analysis was performed for all patients requiring Trauma Team Activation (TTA) at a category one adult Major Trauma Centre (MTC) who were submitted to the TARN database from the 1st January 2015 to the 1st January 2020...

INTRODUCTION: Female sex may provide a survival benefit after trauma, possibly attributable to protective effects of estrogen. This study aims to compare markers of coagulation between male and female trauma patients across different ages. METHODS: Secondary analysis of a prospective cohort study at six trauma centers. Trauma patients presenting with full trauma team activation were eligible for inclusion. Patients with a penetrating trauma or traumatic brain injury were excluded...

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Background Variance in the deployment of the trauma team to the emergency department (ED) can result in patient treatment delays and excess burden on ED personnel. Characteristics of trauma patients, including mechanism of injury, injury type, and age, have been associated with differences in trauma resource deployment. Therefore, this retrospective, single-site study aimed to examine the deployment patterns of trauma resources, the characteristics of the trauma patients associated with levels of trauma resource deployment, and the deployment impact on ED workforce utilization and non-trauma ED patients...

INTRODUCTION: Sickle cell disease (SCD) is associated with vaso-occlusive events (VOEs) that can lead to disease complications, including early mortality. Given that similar inflammatory responses characterize VOE and traumatic injury, injured patients with SCD may be vulnerable to acute complications. This study is the first to examine whether traumatic injury is associated with increased severity of future VOEs. METHODS: This cohort study was conducted using electronic health record data from an SCD clinic in Western Pennsylvania; 356 patients with SCD from January 2000 to July 2021 were identified via retrospective chart review...

BACKGROUND: Trauma team activation (TTA) allows the provision of specialized and timely care to improve outcomes for severely injured patients. Limited information is available on the current state of TTA in Canadian trauma centres (TC). Study objectives were to describe TTA processes, data and reports, along with the challenges and successes from a national perspective. METHODS: A mixed-methods, cross-sectional survey was undertaken with Canadian trauma leadership, utilizing a total population sampling strategy...

Background and Objectives : In the context of prehospital care, spinal immobilization is commonly employed to maintain cervical stability in head and neck injury patients. However, its use in cases of unclear consciousness or major trauma patients is often precautionary, pending the exclusion of unstable spinal injuries through appropriate diagnostic imaging. The impact of prehospital C-spinal immobilization in these specific patient populations remains uncertain. Materials and Methods : We conducted a retrospective cohort study at Taipei Tzu Chi Hospital from January 2009 to May 2019, focusing on trauma patients suspected of head and neck injuries...